First do no harm: Principles of care for clients with sexual identity confusion and/or conflict.

Individuals who experience sexual identity confusion and/or conflict face unique stressors and life circumstances for which they may seek psychotherapy; however, little specific guidance exists for therapists working with clients who experience sexual identity confusion and/or conflict. To meet this need, we present a framework for therapists whose clients experience distress related to sexual identity confusion and/or conflict. We first define and describe sexual identity confusion and conflict, situating both in developmental theories of sexual identity. We then review clinical approaches that have been used historically to inform treatment with clients experiencing sexual identity confusion and/or conflict. Next, we discuss guiding ethical and clinical principles to inform such a clinical approach. Then, we provide assessment and treatment recommendations. We conclude by discussing considerations for working with clients who are diverse in gender identity, race/ethnicity, age, sexual orientation, and religious affiliation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Ethnic variations in suicide method and location: An analysis of decedent data.

This study analyzed ethnic variations in suicide method and suicide location for 1,145 suicide deaths in a diverse California county. Hanging was the most common method of suicide death. Latino/a/x and Asian and Pacific Islander (API) decedents were more likely to suicide-by-hanging; White and African American decedents were more likely to suicide-by-firearms. API and African American decedents were less likely than White decedents to die-by-suicide at home. Suicide location can be predicted by the co-occurring influence of ethnicity and suicide method. Implications focus on culturally-informed suicide prevention research, assessment, and risk management.

Responding to gender and sexual minority stress with functional analytic psychotherapy.

Despite an overwhelming literature detailing the impact of societal bias on the well-being and relationships of gender and sexual minority clients, as well as greater rates of help-seeking from mental health professionals, recent advances in minority stress research have not been fully incorporated into clinical practice. Minority stress factors such as internalized stigma, rejection sensitivity, and concealment interfere with vulnerable and intimate relationships, and likely contribute to the transdiagnostic challenges that GSM clients report, such as loneliness and social isolation (Mereish & Poteat, 2015). Further, behavioral patterns emphasizing inauthentic self-presentation are common interpersonal styles of stigma management (Pachankis & Hatzenbuehler, 2013). Functional analytic psychotherapy is interpersonal therapy grounded in a behavior analytic approach to the therapeutic relationship, which was developed to promote generalizable change in intimate and vulnerable behaviors with meaningful others (Kohlenberg & Tsai, 1991). Functional analytic psychotherapy emphasizes the role of contingent responding by the therapist to clinically relevant behaviors, to increase vulnerable, interpersonal risks that can be responded to in a warm and compassionate way. FAP is ideal for adaptation to target the interpersonal aspects of minority stress on gender and sexual minority clients that often include histories of punishment in response to vulnerable authenticity, possibly even by past therapists (e.g., Flentje, Heck, & Cochran, 2014; Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). (PsycINFO Database Record

A Shortened Screener Version of the Cultural Assessment of Risk for Suicide.

The current study aimed to establish a shortened version of the Cultural Assessment of Risk for Suicide (CARS) measure that can be more widely utilized under time constraints in clinical and applied settings. Based on a sample of 485 adults, confirmatory factor analysis, bivariate correlations, and Receiver-Operating Characteristic analyses were employed to determine the most psychometrically valid shortened version. The 14-item, 8-factor CARS screener (CARS-S) evidenced high reliability, high correlation with the original full version of the CARS questionnaire, and high convergent validity with measures of other suicide-related constructs of depression, hopelessness, suicidal ideation, and lifetime suicide attempts. The suggested clinical cut-off is 38.5. The shortened CARS-S offers a time-efficient assessment of cultural suicide risk factors.